Individual provider Active NPI

Tyler John Emmert, D.C.

  • Chiropractor
  • Salem, OR
National Provider Identifier
1801133129
Registry record updated Aug 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5111 Issued in OR
Practice address
4356 Commercial St SE
Salem, OR 97302-3914
Phone
(503) 482-2483
Fax
(503) 388-7629
NPI assigned
Jan 7, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 24, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 5111 OR Primary

Addresses

Primary practice location

4356 Commercial St SE
Salem, OR 97302-3914

Mailing address

2504 Shipman LN SE
Salem, OR 97317-9236
Phone (541) 359-7770

Other practice location 1

4050 Fairview Industrial Dr SE Ste 100
Salem, OR 97302-1006
Phone (541) 359-7770

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130416000353 OR Practitioner - Chiropractic 2961648068

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5111ORMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Core Chiropractic, LLC, Dba: Core Sport and Spine Chiropractor CurrentSince May 8, 2022 Accepting new patients
Emmert Chiropractic Company PastSince Sep 7, 2016 Accepting new patients
Cornerstone Chiropractic, LLC Chiropractor PastSince Dec 17, 2009 Accepting new patients

Locations

4050 Fairview Industrial Dr SE
Ste 100
Salem, OR 97302
Phone (541) 359-7770

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1357516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787529600000",
    "number": "1801133129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2504 SHIPMAN LN SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973179236",
            "telephone_number": "541-359-7770",
            "fax_number": "503-388-7629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4356 COMMERCIAL ST SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973023914",
            "telephone_number": "503-482-2483",
            "fax_number": "503-388-7629"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4050 Fairview Industrial Dr SE Ste 100",
            "address_purpose": "LOCATION",
            "city": "Salem",
            "state": "OR",
            "postal_code": "973021006",
            "country_code": "US",
            "telephone_number": "541-359-7770",
            "fax_number": "503-388-7629",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EMMERT",
        "first_name": "TYLER",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-01-07",
        "last_updated": "2026-08-24",
        "certification_date": "2026-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OR",
            "license": "5111",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.